This document is the Form W-8BEN, which is used by foreign individuals and entities to certify their foreign status for U.S. tax withholding purposes. The form includes sections for identifying the beneficial owner, claiming tax treaty benefits if applicable, certifying the owner's foreign status, and authorizing the form to be provided to withholding agents. Key information the form requests includes the owner's name, address, country of residence or incorporation, tax identification numbers, and certification of items including not being a U.S. person and the income not being effectively connected to a U.S. trade or business.